[Hysteroscopic cure under ultrasonic control of complex and/or recurrent uterine synechiae]

Hysteroscopy now plays a major role in the rapidly changing therapeutic approach to the diagnosis and treatment of uterine synechiae. The fibrous nature of the lesion and its precise localization can be determined. Operative hysteroscopy has greatly benefited from technological progress in optic fibers and instrumentation. It is now possible to control the endocavitary operation with a video-endoscope. In this report, we present preliminary results obtained in 11 patients who underwent echo-controlled hysteroscopic surgical cure of complex and/or recurrent uterine synechiae. The intra-operative echographic control was validated in the operating theatre radiographically. Intra-operative echography allowed hysteroscopic lysis of intrauterine adhesions at a controlled and equivalent distance from the uterine walls. It is thus possible to better treat the uterine cornua since the operator is informed when to limit progression to avoid massive fluid infusion into the abdominal cavity and perforation of the uterus. With this technique we obtained 8 normal cavities with bilateral tube permeability. Normal cycles were achieved in 10 patients. The effect of this newly developed technique on improving fertility cannot yet be established.